Use Cautiously in: Severe hepatic impairment; Obstetric: Use only if clearly needed; Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

dizziness

fatigue

Gastrointestinal

abnormal liver function tests

abdominal pain

diarrhea

Genitourinary

albuminuria

Endocrinologic

abnormal vaginal bleeding

gynecomastia

Fluid and Electrolyte

hyperkalemia (life-threatening)

Metabolic

hypercholesterolemia

hypertriglyceridemia

Miscellaneous

flu-like symptoms

Interactions

Drug-Drug interaction

Concurrent use of strong inhibitors of the CYP3A4 enzyme system (ketoconazole, itraconazole, nefazodone, clarithromycin, ritonavir, or nelfinavir ) significantly ↑ effects of eplerenone; concurrent use contraindicated. Concurrent use of weak inhibitors of the CYP3A4 enzyme system (erythromycin, saquinavir, fluconazole, verapamil ) may ↑ effects of eplerenone; initial dose of eplerenone should be ↓ by 50%.NSAIDs may ↓ antihypertensive effects.Concurrent use of ACE inhibitors or Angiotensin II receptor blockers may ↑ risk of hyperkalemia.

HF Post-MI

Availability (generic available)

Tablets: 25 mg, 50 mg

Nursing implications

Nursing assessment

Monitor BP periodically during therapy.

Monitor prescription refills to determine adherence.

Lab Test Considerations: May cause hyperkalemia. Monitor serum potassium levels prior to starting therapy, within the first wk, at 1 mo following start of therapy or dose adjustment and periodically thereafter. Monitor serum potassium and serum creatinine in 3–7 days in patients who start taking a moderate CYP3A4 inhibitor.

Eplerenone (Inspra) was also shown to trim troublesome and costly repeat heart failure hospitalizations in a sublet of patients followed for up to 10 additional months after the pivotal, phase III trial closed, Dr.

Eplerenone (Inspra) was also shown to trim troublesome and costly repeat heart failure hospitalizations in a subset of patients followed for up to 10 additional months after the pivotal, phase III trial closed, according to Dr.

"We are proud to recognize the winners of the 2018 Communications Contest, whose outstanding work exemplifies the best in school communications throughout the state," said INSPRA President Becky Koltz, who is coordinator of communications & community relations at Community High School District 94.

A new addition in the guidelines is use of an aldosterone receptor blocker, either spironolactone or eplerenone (Inspra) for patients with a left ventricular ejection fraction of 40% or less and either symptomatic heart failure or diabetes, as long as they don't also have significant renal dysfunction or hyperkalemia.

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